Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Hand/UE 3 > Traumatic Injuries > Flashcards

Traumatic Injuries Flashcards

1
Q

surgical procedures used to treat complex hand injuries - skin (3)

A
  1. skin sutured in primary repair
  2. graft/flap placed for wound coverage
  3. skin left open for secondary closure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

surgical procedures used to treat complex hand injuries - tendons (2)

A
  1. flexors/extensors repaired

2. tendon grafts, transfers, tendon removal performed in prep for future graft (often w/ temporary spacer)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

surgical procedures used to treat complex hand injuries - nerves

A

nerves repaired with or without grafting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

surgical procedures used to treat complex hand injuries - blood vessels

A

veins and arteries repaired with or without grafting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

surgical procedures used to treat complex hand injuries - bone (3)

A
  1. bone fixation performed
  2. joint arthroplasty implant inserted where joint surfaces cannot be repaired
  3. joint fusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

order of repair in traumatic hand injuries

A
  1. bone fixation
  2. tendon (unless vascular status severely compromised)
  3. vascular and nerve repair
  4. skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

general info needed from physician/surgeon (4)

A
  1. what to hold and what to move
  2. what was injured, at what level, and what was repaired
  3. what type of injury
  4. what are expected outcomes/goals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

info needed from surgeon following surgical repairs (11)

A
  1. structures repaired and how
  2. quality of repairs
  3. strength of repairs
  4. any tension on repairs
  5. tendon quality/repair site in relation to pulleys
  6. strength of any fracture fixation; presence of fusions; joint mobility; bone shortening
  7. any skin graft/flap precautions required
  8. any tissues/ROM to be protected
  9. any tissues with questionable viability that need to be watched
  10. anticipated time frames for progression
  11. any structures not repaired/plans for them
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

types of bone fixations (7)

A
  1. bone grafts
  2. fixators
  3. wires
  4. pins
  5. plates
  6. screws
  7. other devices
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

bone injury precautions (2)

A
  1. Avoid excess stress at the fracture or fusion site or pin site and watch for signs of infection.
  2. A joint next to a fracture may need to be moved to begin ROM protocols. Be aware of the location and type of fracture and the fixation and stability. Manually stabilize the bone during movement, and do not torque across the fracture site.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ROM and bone injuries

A

if the surgeon established sufficient fracture fixation, ROM around fracture site may be initiated immediately, starting from midrange and progressing to full ROM as appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

revascularizations precautions (11)

A
  1. keep hand warm and avoid exposure to cold or sudden/extreme temperature change
  2. no eating/drinking anything vasoconstrictive (caffeine/chocolate)
  3. no smoking
  4. no compressive bandages until vascular status is stable
  5. prevent compression from orthosis material and straps
  6. constantly monitor color of the fingers with regards to capillary refill
  7. no cold treatments in acute phase
  8. do not use a whirlpool because it puts hand in dependent position
  9. do not use contrast baths
  10. mild heat may be used once vascularity has stabilized, but insensate hand does not have warning system for heat and cannot dissipate heat as well
  11. no extreme elevation (above level of heart)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

dusky (grayish) finger/hand

A

indicates severely diminished vascularity caused by arterial compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

purple colored finger/hand

A

indicates severely diminished vascularity caused by venous congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

exercise and revascularization

A

should be performed in a warm room away from AC vents with the dressing off so the OT can monitor color, capillary refill, and temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

nerve injury clinical reasoning (3)

A
  1. important to educate client in care of hand
  2. after regained protective sensation, begin sensory reeducation
  3. be aware that not only do that have problems sensing temperature, but they also have problems dissipating heat as well
17
Q

positioning for replant or if both flexors and extensors are lacerated

A

position similar to one for flexor tendon injury

*priority is given to flexors over extensors because flexion is more important for function

18
Q

edema

A
  • causes increased resistance with AROM
  • longstanding edema increases scar formation
  • compression may be used after vascular system stabilizes
19
Q

delayed mobilization protocol (DMP) for replants

A

used mostly for young children or clients who may not be fully cooperative

20
Q

DMP 0-3 weeks

A

no ROM

21
Q

DMP 3 weeks

A

AROM of involved structures

PROM of uninvolved structures

22
Q

DMP 4 weeks

A

NMES

neuromuscular e-stim

23
Q

DMP 6 weeks

A

dynamic orthosis
PROM of involved structures
initiate use of hand for ADLs

24
Q

DMP 8-10 weeks

A

strengthening exercises

25
Q

early mobilization protocol for replants (EPM)

A

used for digital or hand replants characterized by stable fixation and a clean injury

26
Q

EPM 4-10 days

A
  • EPM I
  • MP extension with wrist flexion
  • MP flexion with wrist extension
27
Q

EPM 7-14 days

A
  • EPM II passive
  • continue EPM I
  • passively move client’s fingers between “table”
  • MP flexion with IP extension (intrinsic plus) and hook
  • MP extension and IP flexion (
28
Q

EPM 14-21 days

A
  • EPM II active
  • continue EPM I and EPM II passive
  • Place and hold hook and table positions
  • progress to active hook and table
  • isolated FDS tendon exercises
  • interossei strengthening (intrinsic plus)
  • light functional activities
29
Q

EPM 28 days

A
  • increase wrist extension to full with flexed fingers
  • progress to full AROM and finger PROM
  • begin gentle blocking exercises
30
Q

EPM 6 weeks

A
  • NMES
  • passive stretching of involved structures
  • full nonresistive use for ADLs (precautions for insensate hand)
  • dynamic orthosis use
31
Q

EPM 8 weeks

A

*light strengthening exercises

32
Q

tendon repair precautions (3)

A
  1. protect against a full active fist or full extension of the fingers
  2. avoid resistance from excessive co-contraction in early stages
  3. edema increases resistance during early ROM exercise so modify your approach if you encounter resistance
33
Q

fracture precautions (2)

A
  1. avoid excess stress at fracture, fusion, or pin sites when mobilizing a complex injury
  2. if revascularization has been done in conjunction with fracture fixation, expect delayed healing or nonunion as a result of a decrease in the delivery of nutrients to the area
34
Q

nerve injury and repair precautions (4)

A
  1. nerve injuries leave part of the hand insensate, so teach client to use caution with ADLs
  2. use caution with use of dynamic or static progressive orthoses and any other external compression because of the lack of a warning system for ischemia
  3. use heat and ice treatments cautiously
  4. remind the client that cold intolerance and pain after nerve injury is common for 2+ years
35
Q

incision, wound, and graft precautions (3)

A
  1. make sure that dressings do not exert shear or mechanical stress on healing wounds
  2. prevent maceration while maintaining a moist wound bed
  3. avoid using cytotoxic chemicals on granulating wound tissue

Hand/UE 3 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions